For its original architects, who have spent the last four years watching then-President Donald Trump and fellow Republicans try to eliminate and wipe out Obama’s signature program, it represents a deeply satisfying resurgence.
Obama’s chief health adviser Nancy-Ann DeParle said it needed to be further strengthened after the ACA was created. “President Biden and Vice President Harris said they were going to do it, and they are doing it.”
For obvious reasons, Biden holds a strong stake in the success of the program. As vice president, he was also present in the creation of a program that whispered in Obama’s ear, fulfilling the Democratic Party’s decades-old desire for a national health plan for a “big f —— deal”. Used to represent.
He proposed to make medical qualifications available to a larger new population of Americans, with the eligibility age being reduced from 65 to 65. And they also made available a new Medicare-style “public option” by their employers to offer health insurance coverage.
Both of those proposals are facing tough political enthusiasts in Congress, particularly with the White House spending massive economic reforms on physical infrastructure and other priorities to focus its current legislative push. Meanwhile, Biden used the Kovid relief bill to make a major health-policy down payment.
According to Larry Leavitt of the Kaiser Family Foundation, the steps involved could help increase coverage for 29 million Americans currently without health insurance by more than a third. In addition to expanding the breadth and depth of subsidies to procure Obamaker policies, the Kovid Relief Bill provided enormous new financial incentives for states to expand their Medicaid programs under the provisions of the ACA.
The expansion under Obamacare extends Medicaid coverage to people with incomes below 138% of the federal poverty level. Twelve states – 10 of which Trump ran in both of his presidential campaigns – have opposed doing so since the ACA came into force in 2010.
But Biden and his outside colleagues have not given up. The liberal advocacy group Protect Our Care has launched a public campaign to pressure “GOP Medicaid Deniers”, while health policy experts close to the administration seek alternatives if holdouts persist.
“We have found a way to involve this group,” said Sharon Parrott, president of the Center on Budget and Policy Priorities.
And DeParle predicted the Biden administration would “be very creative” about overcoming linguistic resistance.
Later this month, the second part of Biden’s economic reform agenda – an “American Family Plan” to help struggling families climb the economic ladder – could sketch an approach. One possibility under discussion: a limited-purpose public insurance option for those trapped in a holdout “Medicaid Coverage Gap.”
The extended premium subsidy in the Kovid relief bill lasts for only two years. The White House wants to make them permanent, but this requires additional legislation.
Nor has Biden eliminated a potential legal threat to Obamacare. The Supreme Court has not yet ruled on a lawsuit by three judges appointed by Trump, reinstated by Republican-led states, to declare the ACA unconstitutional.
But many legal experts expect the court to uphold the law once again. Chief Justice John Roberts and Trump’s appointment Brett Kavanuagh suggested as much during an oral debate last November.
Public support for the law has actually increased during the extended legal and political trial by fire. Trump and the Republican-led Congress almost repeated this in 2017, with voters ceding full control of the Democrat House in 2018 and then Congress and the White House in 2020.
Now under Biden’s patronage, the achievement of Obama’s legacy is likely to remain a durable feature of the American landscape. Invoking the previous generation of television advertising for a watch, DeParley concludes: “Takes a lickin ‘and stays on tikin.”